When Suicide Is at Stake: Some Thoughts on the Therapeutic Space between Therapists and Adolescents

Looking at adolescence as a period of turmoil as well as abrupt physical and mental changes, it is not surprising that in western countries suicide is the primary cause of death in adolescents and young adults ages 15–24. Most therapists treating adolescents encounter patients who frequently engage in suicidal behavior. This significantly challenges the therapeutic bond and influences the therapeutic space in a unique way. In this article, we address the challenges specific to the therapeutic alliance in treating adolescents presenting suicidal behaviors. While literature on the nature of the therapeutic bond with adult suicide attempters is available, literature on the distinguishing characteristics of the therapeutic bond with adolescent attempters is lacking. Two vignettes are presented to illustrate this distinctive alliance.